Bilateral true hermaphroditism

Case contributed by Dr Ammar Haouimi

Presentation

Married patient with a history of neglected primary amenorrhea

Patient Data

Age: 25 years
MRI

The uterus is small in size (hypoplastic uterus). The upper vagina is distended with fluid content of low signal intensity on T1WI, T2WI and gradient echo (haematocolpos, chronic phase). The sequences with vaginal filling show an opacification of the lower third only, most likely due to a transverse vaginal septum at the junction middle/lower thirds.

Both ovaries are well-visualized, containing small follicles.

Note two oval structures well-visualized in the paravesical regions, mainly on coronal T2WI, of intermediate signal intensity on T1WI and T2WI, measuring 24 x 9 mm on the right and 20 x 11 mm on the left side, highly suggestive of testes.

Case Discussion

True hermaphroditism is considered as the presence of both ovarian and testicular tissues in a single individual 1. It may be in the same gonad (ovotestis) or separate gonads. The karyotypes found in this condition are: 80% (46 XX), 10% (46XY), and 10% (mosaicism) 2.

Additional contributors: R Bouguelaa, MD and A Ramdani, MD

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Case information

rID: 63833
Published: 22nd Oct 2018
Last edited: 23rd Oct 2018
System: Gynaecology
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria

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